Provider Demographics
NPI:1407942493
Name:RODRIGUEZ, CHRISTIAN COELLO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:COELLO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8 PROSPECT ST
Mailing Address - Street 2:NORTH II SPECIALTY
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3925
Mailing Address - Country:US
Mailing Address - Phone:603-577-3070
Mailing Address - Fax:603-577-3075
Practice Address - Street 1:8 PROSPECT ST
Practice Address - Street 2:NORTH II SPECIALTY
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3925
Practice Address - Country:US
Practice Address - Phone:603-577-3070
Practice Address - Fax:603-577-3075
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH128172086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30205247Medicaid
020456218OtherCOMMERCIAL
NH01Y008576NH01OtherANTHEM BC/BS
I12163Medicare UPIN
NHRE8397Medicare ID - Type Unspecified